Nephrology is the branch of internal medicine dealing with the study of the function and diseases of the kidney

Patients are referred to nephrology specialists for various different reasons, such as:

∙          Acute renal failure, a sudden loss of renal function

∙          Chronic renal failure

∙          Hematuria (blood loss in the urine).

∙          Proteinuria the loss of protein especially albumin in the urine

∙          Kidney stones

∙          Cancer of the kidney, mostly renal cell carcinoma but this is usually the domain of the urologist.

∙          Chronic or recurrent urinary tract infections.

∙          Hypertension that has failed to respond to multiple forms of anti-hypertensive medication or could have a secondary cause

∙          Electrolyte disorders or acid/base imbalance.

∙          Diseases of the Bladder and prostate such as malignancy, stones, or obstruction of the urinary tract.

Laboratory tests are almost always aimed at: urea, creatinine, electrolytes, and urinalysis-- which are frequently the key test in suggesting a diagnosis.
More specialized tests can be ordered to discover or link certain systemic diseases to kidney failure such as hepatitis b or hepatitis c, lupus serologies, paraproteinemias such as amyloidosis or multiple myeloma or various other systemic diseases that lead to kidney failure. Collection of a 24-hour sample of urine can give valuable information on the filtering capacity of the kidney and the amount of protein loss in some forms of kidney disease. However, 24-hour urine samples have recently, in the setting of chronic renal disease, been replaced by spot urine ratio of protein and creatinine.
Other tests often performed by nephrologists are:

∙          Renal biopsy, to obtain a tissue diagnosis of a disorder when the exact nature or stage remains uncertain.

∙          Ultrasound scanning of the urinary tract and occasionally examining the renal blood vessels;

∙          CT scanning when mass lesions are suspected or to help diagnosis nephrolithiasis;